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55 Cards in this Set
- Front
- Back
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The ear is responsiable for?
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sensory organ for hearing and maintaining equilibrium
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Anatomy of external ear contains 6 parts, what are they?
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-helix
-mastoid process -external auditory meatus -tragus -lobule -external auditory canal |
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What is the tympanic membrane?
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-separates external from the middle ear
-translucent membrane with pearly gray color |
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Middle ear what is it and what are the names of the bones in it?
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-tiny airfilled cavity inside temporal bone
-contains tiny ear bones or ossicles: -alleus -incus -stapes (in oval window) |
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What are the opening to the inner ear?
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-oval window
-round window |
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What is the opening to nasopharynx?
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-eustachian tube
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-What are 3 functions of the middle ear?
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-conducts sound vibrations from outer to inner ear
-protects inner ear -eustachian tube = pressure |
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Inner ear contains what?
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-contains bony labyrinth which holds sensory organs for:
-hearing -equilibrium -lined with fluid |
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What are the sensory organs that help aid in hearing?
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-vestibule
-semicircular canals (receptors for balance) -cochlea (receptor for hearing, organ of corti) -cranial nerve VIII |
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Organ of Corti
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-organ of hearing
-contains hair cells |
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Conductive hearing loss
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-dysfunction of external or middle ear
-inner ear still intact -causes due to wax, foreign bodies, perforated Tam, pus in middle ear, otosclerosis |
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Sensorineural loss
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-vibrations transmitted to inner ear, but cochlea or auditory nerve not working well
-sound waves not transferred -results are HOH |
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Common causes of hearing loss
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-presbycusis-grandual nerve degeneration that occurs w/ aging and ototoxic drugs
-exposure to loud noise |
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Mixed hearing loss
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-conductive and sensorineural combined
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Physical assessment, subjective data.
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-earaches
-infections -discharge -hearing loss -environmental noise -tinnitus -vertigo -self-care habits |
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Physical assessment objective data
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-size and shape
-position and alignment -skin condition -tenderness -drainage |
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Tests for hearing acuity
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-audiometry-most popular
-whisper test -tuning fork test |
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What does the tuning fork tests do?
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-help differentiate between conductive and sensorineural hearing loss
-measure hearing by air conduction (AC) and bone conduction (BC) |
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Weber test
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-fork on top of the head
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Rinne test
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-behind the ear to around to the fron of the ear
-measured in seconds |
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What is cerumen impaction and what are some causes?
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-wax build-up in the ear
-causes include too marrow canal -cleaning habits |
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Clinical signs of cerumen impaction
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-otalgia (pain in ear)
-feeling of fullness -loss of hearing |
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Management of cerumen impaction
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-irrigation with water
-suction -instrumentation -mineral oil -cerumenolytic agents (ceramex) 2-3x per day for several days |
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Foreign bodies removal
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-non-swelling objects can be irrigated
-vegetable foreign bodies will have to be removed with suction or instrumentation due to swelling -insects-kill with oil drops -may need surgery |
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Otitis externa and causes
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-inflammation of external ear
-causes include swimmer's ear -bacterial or fungus -trauma to skin of ear canal -allergic reactions |
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Clinical manifestations of otitis externa
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-pain
-discharge-yell/green, foul smelling -aural tenderness -fever, hearing loss, feeling of fullness -ear canal red and swollen |
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Medical management of otitis externa
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-relieve discomfort 48-92hrs
-decrease swelling -get rid of infection -combined antibacterial w/ corticosteroid ear drops -antifungal ear drops -avoid water |
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Malignant otitis externa
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-serious but rare form of external ear infection
-usually progressive, debilitating, and sometimes fatal -found more commonly in diabetics |
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Treatment for malignant otitis externa
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-IV antibiotics becuase it's an inner ear problem and needs to get past the membrane
-control of diabetes -agressive local wound care -debridement of tissue, bone,and cartilage |
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Malignant tumors of the external ear
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-basal cell on the pinna
-squamous cell in the ear canal -must be treated sugically |
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trauma of the tympanic membrane resulting in perforation can result from
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-skull fracture, explosive injury, or blow to the ear
-foreign object -infection |
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Management of tympanic membrane perforation
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-heals spontaneously within weeks; some may take several months
-must be protected from water -may require tympanoplasty (tissue is placed across perforation to allow healing) |
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Acute otitis media
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-acute infection of the middle ear, usually lasting less than 6 weeks
-mode of entry usually through eustachian tube |
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clinical signs of otitis media
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-usually unilateral
-purulent exudate-loss of hearing -otalgia-relieved by spontaneous rupture of TM -may have drainage from ear, fever -TM red and bulging |
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Management of otitis media
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-early and appropriate antibiotic therapy
-combine antibacterial w/ corticosteroid -permanent hearing loss is rare -secondary complications are rare: mastoiditis, meningitis, brain abcess |
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Serous otitis media
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-fluid in middle ear w/o infection
-usually due to blocked eustachian tube -primarily in children |
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Clinical signs of serous otitis media
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-hearing loss
-plugged feeling in ears |
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Management of serous otitis media
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-usually no tx unless infection is present occurs
-may do myringotomy (incision in tM) which relieves pressure; heals within 24-72 hrs |
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chronic otitis media
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-irreversible tissue pathology; due to repeated episodes of acute otitis media
-associated with persistent perforation of the TM -symptoms similar to acute otitis media but not usually as severe |
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otosclerosis
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-soft spongy bone growth around oval window resulting in fixation of stapes
-surgery involves stapedectomy with prosthesis -usually very successful in improving hearing |
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Motion sickness
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-condition of inner ear
-disturbance of equilibrium -vestibular overstimulation |
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symptoms of vestibular overstimulation (motion sickness)
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-pallor,
-sweating -nausea -vomiting |
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Management of motion sickness
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-antihistamines-dramamine, bonine
perscriptions- scopalamine patches |
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Menier's Disease and it's triad of symptoms
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-too much circulating fluid in the ear
-Triad includes: episodic incapacitating vertigo can cause N/V -tinnitus or roaring sound -fluctuating progressive sensorineural hearing loss |
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Managment of menier's
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-treated with diet and medication (low sodium diet 2000mg/day)
-avoid caffeine, alcohol and nicotine |
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Pharmacologic therapy of Meniere"s
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antihistamines-suppresses the vestibular system
-antimetics-phenergan -diuretics |
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Management of menier's
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-may require surgical intervention
-shunt in endolymphatic sac (75% success rate) -vestifular nerve resection |
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Labyrinthitis
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-inflammation of the inner ear (can be bacterial or viral)
-bacterial=meningitis or otitis media -viral=mumps, measles, influenzq |
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Clinical signs of labyrinthitis
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-incapacitating vertigo
-N/V -varying degrees of hearing loss -possible tinnitis |
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Management of labyrinthitis
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-bacteria-IV antibiotics, fluid replacement, antiemetics, vertigo suppressant
-viral-as above w/o antibiotics |
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ototoxicity
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-Caused by ASA and quinine which are reversible
-Lasix and gentamicin |
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Acoustic neuroma
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-slow growing benign tumor
-MRI w/ contrast to visualize the tumor |
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symptoms of acoustic neuroma
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-unilateral tinnitis
-hearing loss with or without vertigo |
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Treatment of acoustic neuroma
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-surgical removal
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Complications of acoustic neuroma
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-may cause facial paralysis
-cerebrospinal fluid leaks -menigitis -cerebral edema -3% mortality rate |
